老年人腰椎位置觉重测信度研究
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摘要
目的观察老年人在站立位时腰椎被动位置觉的重测信度。方法筛选社区老年健康志愿者58例,利用等速训练系统,位置觉重现法,测试腰椎前屈15°、30°、60°和背屈15°目标角度,计算绝对误差角度(AE)。1周后再次测试。计算组内相关系数(ICC)和标准误差(SEM,SEM%)。结果两次测试ICC=0.699～0.833,SEM=1.18～3.26,SEM%=26.84%～37.13%。其中男性ICC=0.462～0.818,SEM=1.60～3.68, SEM%=36.37%～48.78%;女性ICC=0.782～0.891, SEM=1.48～2.71, SEM%=28.48%～33.34%。结论老年人站立位被动位置测试重测信度较好,但误差范围较大,需进一步探索更合适的方法。
Objective To determine the test-retest reliability of lumbar passive reposition accuracy for older people.Methods A total of 58 healthy older people stood on an isokinetic dynamometer, and passively moved their trunk forward and backward to the target positions as accurately as possible. The targeted positions were set as flexion forward 15°, 30° and 60°, and flexion backward 15°. The absolute error(AE) was recorded. They were tested again a week latter. The intraclass correlation coefficient(ICC) and standard errors of measurement(SEM and SEM%)were calculated.Results The ICC of AE was 0.699 to 0.833 for all the subjects, SEM was 1.18 to 3.26, and SEM% was 26.84% to 37.13%. For the men, the ICC was 0.462 to 0.818, SEM was 1.60 to 3.68, and SEM% was 36.37% to 48.78%.For the women, the ICC was 0.782 to 0.891, SEM was 1.48 to 2.71, and SEM% was 28.48% to 33.34%.Conclusions Lumbar passive reposition accuracy is some reliable to assess the position sense for older people. However,there are too large errors for clinical measurement, which need further improvment.
Objective To determine the test-retest reliability of lumbar passive reposition accuracy for older people.Methods A total of 58 healthy older people stood on an isokinetic dynamometer, and passively moved their trunk forward and backward to the target positions as accurately as possible. The targeted positions were set as flexion forward 15°, 30° and 60°, and flexion backward 15°. The absolute error(AE) was recorded. They were tested again a week latter. The intraclass correlation coefficient(ICC) and standard errors of measurement(SEM and SEM%)were calculated.Results The ICC of AE was 0.699 to 0.833 for all the subjects, SEM was 1.18 to 3.26, and SEM% was 26.84% to 37.13%. For the men, the ICC was 0.462 to 0.818, SEM was 1.60 to 3.68, and SEM% was 36.37% to 48.78%.For the women, the ICC was 0.782 to 0.891, SEM was 1.48 to 2.71, and SEM% was 28.48% to 33.34%.Conclusions Lumbar passive reposition accuracy is some reliable to assess the position sense for older people. However,there are too large errors for clinical measurement, which need further improvment.
引文
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[2]Juul-Kristensen B,Lund H,Hansen K,et al.Test-retest reliability of joint position and kinesthetic sense in the elbow of healthy subjects[J]Physiother Theory Pract,2008,24(1):65-72.
[3]王雪强,郑洁皎,俞卓伟,等.老年人膝关节和踝关节置觉的重测信度[J].中国组织工程研究,2011,15(35):39-42.
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[11]Georgy E E.Lumbar repositioning accuracy as a measure of proprioception in patients with back dysfunction and healthy controls[J].Asian Spine J,2011,5(4):201-207.
[12]Learman K,Myers J,Lephart S,et al.Effects of spinal manipulation on trunk proprioception in subjects with chronic low back pain during symptom remission[J].J Manipulative Physiol Ther,2009,32(2):118-126.
[13]世界卫生组织.关于老龄化与健康的全球报告[R].日内瓦:世界卫生组织,2015.
[14]Lexell J E,Downham D Y.How to assess the reliability of measurements in rehabilitation[J].Am J Phys Med Rehabil,2005,84(9):719-723.
[15]Wingert J,Welder C,Foo P.Age-related hip proprioception declines:effects on postural sway and dynamic balance[J].Arch Phys Med Rehabil,2014,95(2):253-261.
[16]Lee A,Cholewicki J,Reeves N,et al.Comparison of trunk proprioception between patients with low back pain and healthy controls[J].Arch Phys Med Rehabil,2010,91(9):1327-1331.
[17]Silfies S,Cholewicki J,Reeves N,et al.Lumbar position sense and the risk of low back injuries in college athletes:a prospective cohort study[J].BMC Musculoskelet Disord,2007,8(1):129.
[18]Koumantakis G A,Winstanley J,Oldham J A.Thoracolumbar proprioception in individuals with and without low back pain:intratester reliability,clinical applicability,and validity[J].J Orthop Sports Phys Ther,2002,32(7):327-335.
[19]陈炳霖,郭佳宝,李欣,等.青年慢性非特异性腰痛患者腰部本体感觉及其与肌力的相关性[J].中国康复医学杂志,2017,32(2):187-191.
[20]Dunn W,Griffith J W,Sabata D,et al.Measuring change in somatosensation across the lifespan[J].Am J Occup Ther,2016,69(3):1-9.
[21]Brumagne S,Lysens R,Spaepen A.Lumbosacral position sense during pelvic tilting in men and women without low back pain:test development and reliability assessment[J].J Orthop Sports Phys Ther,1999,29(6):345-351.
[22]Seinstra M,Grzymek K,Kalenscher T.Gender-specific differences in the relationship between autobiographical memory and intertemporal choice in older adults[J].PLoS One,2015,10(9):1-22.
[23]Noh K H,Oh J S,Yoo W G.Comparison of lumbar repositioning error according to different lumbar angles in a flexion pattern(FP)subgroup of patients with non-specific chronic low back pain[J].J Phys Ther Sci,2015,27(1):293-294.
[24]瓮长水,侯惠如,王娜,等.Jamar握力器对老年男性的重测信度和测量误差[J].中国康复理论与实践,2010,16(1):3-5.
[25]Nasseri N,Hadian M R,Bagheri H,et al.Reliability and accuracy of joint position sense measurement in the laboratory and clinic:utilising a new system[J].Acta Med Iran,2007,45(5):396-404.
[26]Swinkels A,Dolan P.Spinal position sense is independent of the magnitude of movement[J].Spine,2000,25(1):98-104.
[2]Juul-Kristensen B,Lund H,Hansen K,et al.Test-retest reliability of joint position and kinesthetic sense in the elbow of healthy subjects[J]Physiother Theory Pract,2008,24(1):65-72.
[3]王雪强,郑洁皎,俞卓伟,等.老年人膝关节和踝关节置觉的重测信度[J].中国组织工程研究,2011,15(35):39-42.
[4]Emilio E J,Hitacontreras F,Jiménezlara P M,et al.The association of flexibility,balance,and lumbar strength with balance ability:risk of falls in older adults[J].J Sports Sci Med,2014,13(2):349-357.
[5]Sipko T,Chantsoulis M,Kuczyński M.Postural control in patients with lumbar disc herniation in the early postoperative period[J].Eur Spine J,2010,19(3):409-414.
[6]Arvin M,Hoozemans M J,Burger B J,et al.Reproducibility of a knee and hip proprioception test in healthy older adults[J].Aging Clin Exp Res,2015,27(2):171-177.
[7]Tong M H,Mousavi S J,Kiers H,et al.Is there a relationship between lumbar proprioception and low back pain?A systematic review with meta-analysis[J].Arch Phys Med Rehabil,2017,98(1):120-136.
[8]王新,舒适,方凡夫,等.慢性非特异性腰痛患者腰椎位置觉与腰肌耐力、疼痛的相关性[J].中国康复理论与实践,2017,23(7):820-823.
[9]Marshall L,Litwack-Harrison S,Makris U,et al.A prospective study of back pain and risk of falls among older community-dwelling men[J].J Gerontol A Biol Sci Med Sci,2017,72(9):1264-1269.
[10]Rausch Osthoff A K,Ernst M J,Rast F M,et al.Measuring lumbar reposition accuracy in patients with unspecific low back pain:systematic review and meta-analysis[J].Spine,2015,40(2):97-111.
[11]Georgy E E.Lumbar repositioning accuracy as a measure of proprioception in patients with back dysfunction and healthy controls[J].Asian Spine J,2011,5(4):201-207.
[12]Learman K,Myers J,Lephart S,et al.Effects of spinal manipulation on trunk proprioception in subjects with chronic low back pain during symptom remission[J].J Manipulative Physiol Ther,2009,32(2):118-126.
[13]世界卫生组织.关于老龄化与健康的全球报告[R].日内瓦:世界卫生组织,2015.
[14]Lexell J E,Downham D Y.How to assess the reliability of measurements in rehabilitation[J].Am J Phys Med Rehabil,2005,84(9):719-723.
[15]Wingert J,Welder C,Foo P.Age-related hip proprioception declines:effects on postural sway and dynamic balance[J].Arch Phys Med Rehabil,2014,95(2):253-261.
[16]Lee A,Cholewicki J,Reeves N,et al.Comparison of trunk proprioception between patients with low back pain and healthy controls[J].Arch Phys Med Rehabil,2010,91(9):1327-1331.
[17]Silfies S,Cholewicki J,Reeves N,et al.Lumbar position sense and the risk of low back injuries in college athletes:a prospective cohort study[J].BMC Musculoskelet Disord,2007,8(1):129.
[18]Koumantakis G A,Winstanley J,Oldham J A.Thoracolumbar proprioception in individuals with and without low back pain:intratester reliability,clinical applicability,and validity[J].J Orthop Sports Phys Ther,2002,32(7):327-335.
[19]陈炳霖,郭佳宝,李欣,等.青年慢性非特异性腰痛患者腰部本体感觉及其与肌力的相关性[J].中国康复医学杂志,2017,32(2):187-191.
[20]Dunn W,Griffith J W,Sabata D,et al.Measuring change in somatosensation across the lifespan[J].Am J Occup Ther,2016,69(3):1-9.
[21]Brumagne S,Lysens R,Spaepen A.Lumbosacral position sense during pelvic tilting in men and women without low back pain:test development and reliability assessment[J].J Orthop Sports Phys Ther,1999,29(6):345-351.
[22]Seinstra M,Grzymek K,Kalenscher T.Gender-specific differences in the relationship between autobiographical memory and intertemporal choice in older adults[J].PLoS One,2015,10(9):1-22.
[23]Noh K H,Oh J S,Yoo W G.Comparison of lumbar repositioning error according to different lumbar angles in a flexion pattern(FP)subgroup of patients with non-specific chronic low back pain[J].J Phys Ther Sci,2015,27(1):293-294.
[24]瓮长水,侯惠如,王娜,等.Jamar握力器对老年男性的重测信度和测量误差[J].中国康复理论与实践,2010,16(1):3-5.
[25]Nasseri N,Hadian M R,Bagheri H,et al.Reliability and accuracy of joint position sense measurement in the laboratory and clinic:utilising a new system[J].Acta Med Iran,2007,45(5):396-404.
[26]Swinkels A,Dolan P.Spinal position sense is independent of the magnitude of movement[J].Spine,2000,25(1):98-104.